MDLinxShould Patients Have to Pay for Messaging Their Doctors Online?

Navigate the rapidly changing landscape of patient communication, as we explore the ins and outs of charging for MyChart messages.

The COVID-19 pandemic has swiftly transformed the dynamics of healthcare communication. Consequently, healthcare providers increasingly rely on telehealth visits and digital communication tools to connect with patients. A significant offshoot of this shift is the growing trend of charging for MyChart messages.

Healthcare systems have begun charging for the time providers spend responding to messages. Some hospitals have even expressed plans to bill up to $50 for MyChart messages. This new approach was permitted through changes to the 2020 Current Procedural Terminology (CPT) codes. The revised codes introduced three new time-based categories, thereby allowing providers to bill for time spent addressing patient-initiated messages over a week.

Despite these changes, not all services come with a price tag. As per the Cleveland Clinic, any work taking under five minutes or any service that leads to an in-person consultation will not be charged. Furthermore, no fees apply to prescription refill requests, appointment requests, and follow-up care related to a surgery performed within the last 90 days.

However, specific services can be billed. For instance, messages necessitating a clinical assessment, ordering a test or medication, or requiring a review of medical history can be charged. Certain prerequisites need to be fulfilled, though, including an established patient-provider relationship, patient-initiated messages, and the development of a management plan.

Billing costs vary based on the patient’s insurance plan. UCSF Health reports that most patients won’t face any costs for using MyChart messages. However, if out-of-pocket expenses arise, they’ll depend on the patient’s insurance type. For instance, costs for Medicare patients will range from zero to minimal. Medi-Cal patients will incur no costs, while private insurance patients may face co-pays similar to in-person visits, or full charges, averaging around $75, if they have a deductible.

In summary, as more healthcare systems begin charging for MyChart messages, transparency about billable and non-billable inquiries becomes critical. Equally important is clear communication about when an in-person visit is required as opposed to a MyChart message. Being abreast of these developments can help physicians better navigate the evolving terrain of telehealth communication.